Field of Invention
[0001] This invention generally relates to intravascular medical device systems that navigable
through body vessels of a human subject. More particularly, this invention relates
to delivery systems and delivery members for delivering and deploying an implantable
medical device to a target location of a body vessel and methods of using the same.
Background
[0002] The use of catheter delivery systems for positioning and deploying therapeutic devices,
such as dilation balloons, stents, and embolic coils, in the vasculature of the human
body has become a standard procedure for treating endovascular diseases. It has been
found that such devices are particularly useful in treating areas where traditional
operational procedures are impossible or pose a great risk to the patient, for example
in the treatment of aneurysms in cranial blood vessels.
[0003] Procedures typically involve inserting a guide catheter (also referred to as a delivery
catheter) into the vasculature of a patient and guiding it through the vasculature
to a treatment site. A vascular occlusion device, such as an embolic coil or braid,
can be attached to an implant engagement/deployment system (referred to herein equivalently
as an "engagement system" or "deployment system") at a distal end a of a delivery
member (e.g. micro-catheter) which pushes the vascular occlusion device through the
guide catheter and out of the distal end of the guide catheter into the treatment
site. Example delivery members and engagement/deployment systems are described in
U.S. Patent Application Number 15/850,993 and
U.S. Patent Application Number 15/964,857 each incorporated herein by reference.
[0004] Applicant recognizes a need for alternative methods, devices, and systems to provide
an implant delivery member and implant engagement system for delivering and deploying
vascular occlusion devices.
Summary
[0005] An example system for deploying an intrasaccular implant to occlude an aneurysm can
include the intrasaccular implant, a pusher tube, a securing wire, and a pull wire.
The intrasaccular implant, pusher tube, securing wire, and pull wire can be sized
to fit within a microcatheter.
[0006] The intrasaccular implant can include a securing ring thereon. The securing ring
can include a proximal surface and an opening having an inner diameter. The opening
of the securing ring can include a substantially circular shape defined by the inner
diameter. The intrasaccular implant can include a braided mesh that is self-expandable
upon exiting the microcatheter. The intrasaccular implant can include a cavity therein.
The intrasaccular implant can include a substantially tubular braided mesh body. The
body can include a first aperture oriented at a first region of the body and a second
aperture oriented at a second region of the body. The securing ring can be disposed
on the first region of the body approximate the first aperture. The second aperture
can correspond to a free open end of the substantially tubular braided mesh body
[0007] The pusher tube can include a distal surface sized to engage the proximal surface
of the securing ring and positioned to face the proximal surface of the securing ring.
A distal region of the pusher tube can be flexible. The distal region of the pusher
tube that is flexible can include a flexibility array. The pusher tube can include
a compressibly resilient portion at a distal region of the pusher tube.
[0008] The securing wire can extend through a lumen of the pusher tube and the opening of
the securing ring. The securing wire can include an extended securing member thereon
positioned on an opposite side of the securing ring in relation to the pusher tube.
The securing member can include a securing member diameter measuring less than the
inner diameter of the opening of the securing ring. The securing member can include
a substantially spherical shape defined by the securing member diameter. The securing
wire can be movable to pass the securing member through the opening in the securing
ring when the pull wire has exited the opening of the securing ring. The securing
wire can be coupled to an inner surface of the pusher tube by an attachment portion.
The securing member can be disposed in the cavity of the implant.
[0009] The pull wire can extend through the lumen of the pusher tube and the opening of
the securing ring. The pull wire can include a pull wire diameter such that the sum
of the securing member diameter and the pull wire diameter measures greater than the
inner diameter of the opening of the securing ring. The pull wire can include a substantially
circularly shaped perimeter defined by the pull wire diameter. The pull wire can be
movable to exit the opening of the securing ring while the securing wire is extended
through the ring. A portion of the pull wire can be disposed in the cavity of the
implant.
[0010] If the pusher tube includes a compressibly resilient portion, the securing wire can
hold the compressibly resilient portion in compression. The securing member of the
securing wire can be engaged to the securing ring, and an elongated portion of the
securing wire can be affixed to the pusher tube in a proximal direction in relation
to the compressibly resilient portion. Tension in the portion of the securing member
extending from a coupling of the securing wire to the inner surface of the pusher
tube to the engagement of the securing member to the securing ring can hold the compressibly
resilient distal region in compression. The compressibly resilient distal region can
be configured to expand and push the securing ring over the securing member when the
pull wire has exited the securing ring.
[0011] An example method for deploying an intrasaccular implant in an aneurysm can include
one or more of the following steps presented in no particular order. The example method
can include additional steps as would be appreciated and understood by a person of
ordinary skill in the art. The example method can be performed using an example system
as disclosed herein, a variation thereof, or an alternative thereto as would be appreciated
and understood by a person of ordinary skill in the art. A system including a microcatheter,
a pusher tube, a securing wire a pull wire, and an intrasaccular implant can be selected.
The system can be selected such that the securing wire includes a radially extending
securing member and the implant includes a securing ring.
[0012] The system can be positioned in a delivery configuration such that pusher tube, securing
wire, pull wire, and implant are positioned within the microcatheter, the pusher tube
is in the proximal direction in relation to the securing ring, the securing wire extends
through the securing ring and pusher tube such that the securing member is positioned
in the distal direction from the securing ring, and the pull wire extends through
the pusher tube and the securing ring.
[0013] The implant can be moved in the distal direction through the microcatheter by moving
the pusher tube, pull wire, and securing wire in the distal direction.
[0014] The intrasaccular implant can be extended into a sac of the aneurysm. The step of
extending the intrasaccular implant into the sac of the aneurysm further can include
allowing the implant to self-expand in the sac.
[0015] The pull wire can be retracted in the proximal direction to free the pull wire from
the securing ring. Retracting the securing wire from the securing ring further can
include retracting the pusher tube in the proximal direction while the securing wire
is coupled to the pusher tube. The securing wire can be retracted from the securing
ring by moving the securing member through the securing ring when the pull wire is
free from the securing ring.
[0016] Attachment of the implant to the pusher tube can be maintained by engaging the securing
member to a distal surface of the engagement ring while engaging a distal surface
of the pusher tube to a proximal surface of the engagement ring. Maintaining attachment
of the implant to the pusher tube further can include inhibiting the securing member
from passing through the securing ring by maintaining the pull wire to extend within
the securing ring.
[0017] An example system for treating an aneurysm can include a microcatheter, a pusher
tube, an intrasaccular implant, a securing wire, and a pull wire.
[0018] The intrasaccular implant can include a securing ring. The securing ring can have
an inner diameter.
[0019] The pusher tube can be oriented within the microcatheter. The pusher tube can include
a compressibly resilient distal region and an inner surface. The pusher tube can include
distal surface at the distal region of the pusher tube, sized to engage a proximal
surface of the securing ring.
[0020] The securing wire can include an extended securing member and an attachment portion.
The securing member can include a securing member diameter measuring less than the
inner diameter of the securing ring. The securing member can be positioned in the
distal direction in relation to the securing ring. The attachment portion of the securing
wire can be coupled to the inner surface of the pusher tube in the proximal direction
in relation to the compressibly resilient distal region of the pusher tube. The securing
member of the securing wire can be engaged to the securing ring.
[0021] The pull wire can be oriented in the pusher tube, extend through the securing ring.
The pull wire can include a pull wire dimension less than the inner diameter of the
securing ring. The sum of the securing member diameter and the pull wire diameter
can be greater than the inner diameter of the securing ring.
[0022] The pull wire can be movable to exit the securing ring while the securing wire is
extending through the securing ring. The compressibly resilient distal region of the
pusher tube can be compressed due to tension in the securing wire over a portion of
the securing wire extending from the securing ring to the coupling of the attachment
portion to the inner surface of the pusher tube. The compressibly resilient distal
region can be configured to expand and push the securing ring over the securing member
when the pull wire has exited the securing ring.
[0023] Another example intravascular treatment system can include an implant, a pull wire,
and a securing wire.
[0024] The implant can include an embolic body and a securing ring affixed to the body.
The securing ring can include a proximal surface, a distal surface, and an opening
including an inner diameter.
[0025] The pull wire having a pull wire diameter can extend through the opening of the securing
ring. The pull wire can be translatable in the proximal direction to exit the opening
in the securing ring.
[0026] The securing wire can extend through the opening of the securing ring. The securing
wire can have an extended securing member thereon and an extended pusher member thereon.
The securing member can be positioned in the distal direction in relation to the distal
surface of the securing ring. The pusher member can be positioned in the proximal
direction in relation to the proximal surface of the securing ring. The securing member
can have a diameter dimensioned such that the sum of the pull wire diameter and securing
member diameter is greater than the inner diameter of the securing ring. The pushing
member can have a diameter dimensioned such that the sum of the pull wire diameter
and the pushing member diameter is greater than the inner diameter of the securing
member. The securing member can be movable to engage the distal surface of the securing
ring when the securing wire is pulled proximally. The pusher member can be movable
to engage the proximal surface of the securing ring when the securing wire is pushed
distally. The securing member and pusher member are each inhibited from moving through
the opening in the securing ring due to the extension of the pull wire through the
securing ring. The securing wire can be translatable in the proximal direction to
exit the opening in the securing ring when the pull wire is absent from the opening.
Brief Description of the Drawings
[0027] The above and further aspects of this invention are further discussed with reference
to the following description in conjunction with the accompanying drawings, in which
like numerals indicate like structural elements and features in various figures. The
drawings are not necessarily to scale, emphasis instead being placed upon illustrating
principles of the invention. The figures depict one or more implementations of the
inventive devices, by way of example only, not by way of limitation.
Figure 1A is an illustration of an example intravascular implant system according
to aspects of the present invention;
Figures 1B and 1C are cross-sectional view illustrations of the example intravascular
implant system as indicated in Figure 1A;
Figures 2A through 2H are a sequence of illustrations of the intravascular implant
system during a treatment according to aspects of the present invention;
Figure 3A is an illustration of an example implant according to aspects of the present
invention;
Figure 3B is an illustration of another example implant according to aspects of the
present invention;
Figure 4A is an illustration of an example flexible portion of a pusher tube according
to aspects of the present invention;
Figure 4B is an illustration of another example flexible portion of a pusher tube
according to aspects of the present invention;
Figures 5A through 5E are a sequence of illustrations during a treatment of an intravascular
implant system having a compressibly resilient distal region according to aspects
of the present invention; and
Figures 6A through 6D are a sequence of illustrations during a treatment of an intravascular
implant system lacking a pusher tube.
Detailed Description
[0028] As used herein, the terms "about" or "approximately" for any numerical values or
ranges indicate a suitable dimensional tolerance that allows the part or collection
of components to function for its intended purpose as described herein. More specifically,
"about" or "approximately" may refer to the range of values ±20% of the recited value,
e.g. "about 90%" may refer to the range of values from 71% to 99%.
[0029] As used herein, the terms "tubular" and "tube" are not limited to a structure that
is a right cylinder or strictly circumferential in cross-section or of a uniform cross-section
throughout its length. For example, the tubular structure or system is generally illustrated
as a substantially right cylindrical structure. However, the tubular system may have
a tapered outer surface, a curved outer surface, and/or a partially flat outer surface
without departing from the scope of the present disclosure.
[0030] As used herein, the term "wire" includes solid core and hollow elongated tubular
structures.
[0031] A system is disclosed herein that can be used to push, track, deploy, position, and
detach an implant at an aneurysm. The system can include an engagement/deployment
system and an embolic implant. The embolic implant can be a braid that is mechanically
attached to the engagement/deployment system, pushed by a delivery pusher (e.g. hypotube)
of the engagement/deployment system to a treatment site using a microcatheter, wherein
the microcatheter is pre-placed at the level of the aneurysm neck and is used to track
the device to the treatment site / lesion. The delivery pusher extends from the proximal
to the distal end of the delivery microcatheter such that a physician can manipulate
a proximal end of the delivery pusher to push the distal end of the delivery pusher
out of the distal end of the microcatheter.
[0032] The engagement/deployment system includes a two wire securing system to secure the
implant to the distal end of the hypotube (delivery pusher). One of the wires can
have a bump, extension, or other such securing feature thereon (referred to herein
as an "securing wire") and the other can have a substantially uniform circumference
(referred to herein as a "pull wire"). The pull wire can be elongated to extend out
of the patient or otherwise be available for manipulation during treatment such that
the pull wire can be pulled proximally in relation to the securing wire.
[0033] The delivery pusher can include a hypotube (metal or polymer) having with a flexible
distal portion. Flexibility of the distal portion of the hypotube can be attained
by cutting a spiral or an interrupted cut through the wall of the hypotube. Additionally,
or alternatively, the pusher can include an extended pushing member formed on the
securing wire in a proximal direction in relation to the securing member on the securing
wire. In examples where the pusher includes a hypotube, the securing wire can be tethered
to the pusher tube. In examples where the pusher lacks a hypotube and includes a securing
member on the securing wire, the securing wire can have an elongated portion that
can be pulled proximally independent of the pull wire.
[0034] The intrasaccular implant can have an annular ring attached to its proximal end to
connect the engagement/deployment system to the implant. To attach the implant to
the engagement/deployment system, the securing feature of the securing wire is inserted
into the annular ring of the implant first, then the pull wire is inserted into the
annular ring of the implant. This secures the implant to the pusher as the inner diameter
of the annular ring is smaller than the diameter of the pull wire plus the diameter
of the securing feature.
[0035] To deploy the implant the pull wire can be retracted, thereby enabling the securing
feature to separate from the implant as the diameter of the securing feature is smaller
than the inner diameter of the annular ring. Once the pull wire is retracted the pusher
tube can be retracted separating the implant from the engagement/deployment system.
[0036] Figure 1A is an illustration of an example intravascular implant system 100 including
an implant 102, pusher tube 106, pull wire 116, and securing wire 120. The implant
102 includes a body 108 that can be an embolic braid, coil, or other such intravascular
occlusion device. The body 108 can include a braid that is sized, shaped, and otherwise
configured for implantation in an aneurysm. Alternatively, the body 108 can be configured
to occlude blood vessels or vascular openings.
[0037] The implant 102 includes a securing ring 112 having a proximal surface SA2, a distal
surface SA3, and an opening 113. The pusher tube 106 can have a lumen 107 therethrough
and a distal surface SA1 sized to engage the proximal surface SA2 of the securing
ring 112. The distal surface SA1 of the pusher tube 106 can be positioned to face
the proximal surface SA2 of the securing ring 112. The securing wire 120 includes
a securing member 114 thereon. When the implant 102 is attached to the pusher tube
106, the securing wire 120 and the pull wire 116 each extend through the lumen 107
of the pusher tube 106 and the opening 113 of the securing ring 112, and the securing
member 114 is positioned on the opposite side of the securing ring 112 in relation
to the pusher tube 106. The pull wire 120 and securing member 114 can be sized such
that when placed side-by-side the securing member is inhibited from passing through
an opening of the securing ring 112. The body 108 of the implant 102 can include a
cavity 110 that is sized such that the securing member 114 and a distal portion of
the pull wire 116 can fit therein when the implant 102 is secured to the pusher tube
106.
[0038] Figure 1B is a cross-sectional view of the system 100 bisecting the securing wire
120 and pull wire 116 and looking in the distal direction as indicated in Figure 1A.
The opening 113 of the securing ring 112 can be substantially circular, having an
inner diameter D1.
[0039] Figure 1C is a cross-sectional view of the system 100 bisecting the securing member
114 and the pull wire 116 and looking in the distal direction as indicated in Figure
1A. The pull wire 116 can have a substantially circular cross section and perimeter
having a diameter D3. The securing member 114 can have a circular cross section having
a diameter D2. The securing member 114 can further have a substantially spherical
shape defined by the circular cross section diameter D2. Alternatively, the securing
member can be longer or shorter along the axis of the securing member 114 while maintaining
the circular cross section diameter D2.
[0040] Referring collectively to Figures 1A through 1C, the sum of the pull wire diameter
D3 and the securing member diameter D2 can be greater than the inner diameter D1 of
the securing ring 112 to thereby inhibit the securing member 114 from passing through
the securing ring 112 when the pull wire 116 is extended through the securing ring
112. The pull wire can be pulled proximally to exit the opening of the securing ring
112. The securing wire 120 is movable to pass the securing member 114 through the
opening 113 in the securing ring 112 when the pull wire 116 has exited the opening
of the securing ring. As illustrated, the securing wire 120 is coupled to an inner
surface of the pusher tube by an attachment portion of the securing wire 120.
[0041] The securing wire 120 can include an elongated portion 121 extending through the
securing ring 112. The elongated portion 121 of the securing wire 120 is smaller in
diameter than the securing member 114 such that the securing member 114 extends radially
outwardly from the elongated portion 121. The elongated portion 121 can be sufficiently
small in diameter to allow the securing wire 120 and pull wire 116 to both be positioned
to extend through the opening 113 of the securing ring 112.
[0042] The pusher can include an elongated hypotube 106. The hypotube can extend through
vasculature 40 of a patient such that the hypotube 106 can be manipulated at its proximal
end to position the implant 102 at a treatment site during treatment. The distal surface
SA1 of the pusher 106 can be sized to engage the proximal surface SA2 of the securing
ring 112 and positioned to face the proximal surface SA2 of the implant 102. The pull
wire 116 can extend through the lumen of the hypotube 106 and can be manipulated at
the proximal end of the hypotube to move the distal end of the pull wire 116 proximally
in relation to the distal portion 122 of the hypotube 106.
[0043] Figures 2A through 2H are a sequence of illustrations of the intravascular implant
system 100 during a treatment.
[0044] Figure 2A illustrates the implant 102 being pushed distally through a microcatheter
104 by a pusher tube 106. The implant 102, pusher tube 106, securing wire 120, and
pull wire 116 are sized to fit within the microcatheter 104. As illustrated, the implant
100 is detachably attached to the pusher tube 106. A securing wire 120 and pull wire
116 are extended through a lumen 107 of the pusher tube 106 and through an opening
113 of a securing ring 112 affixed to the implant 102. Positioned as such, the securing
wire 120, pull wire 116, and securing ring 112 maintain the attachment between the
implant 102 and the pusher tube 106 as the implant 102 is translated through the microcatheter
104. The securing member 114 is inhibited from passing through the opening 113 of
the securing ring 112 by virtue of the position of the pull wire 116 extending through
the opening 113. As illustrated, the elongated portion 121 of the securing wire 120
can be affixed to the pusher tube 106. Alternatively, the elongated portion 121 can
extend through the pusher tube 106, positioned for manipulation near a proximal end
of the system (e.g. outside of a patient). If the securing wire 120 is affixed to
the pusher tube 106, preferably, the securing wire 120 is affixed to an inner surface
118 within the pusher tube lumen 107. Alternatively, the securing wire 120 can be
affixed to an outer surface or distal face of the pusher tube 106; however such position
might expose the securing wire 120 to potential damage during delivery or handling.
As illustrated, the body 108 of the implant 100 includes a braided mesh that is self-expandable
upon exiting the microcatheter 104.
[0045] Figure 2B illustrates the implant 102 being pushed further distally through the microcatheter
104 while remaining detachably attached to the pusher tube 106. The pull wire 116
is maintained in position through the opening 113.
[0046] Figure 2C illustrates the implant 102 pushed distally by the pusher tube 106 from
a distal end of the microcatheter 104 into an aneurysm 50. The implant 102 remains
detachably attached to the pusher tube 106 by virtue of the pull wire 116 and securing
wire 120 extending through the opening 113 of the securing ring 112.
[0047] Figure 2D illustrates the implant 102 expanding with the sac 132 of the aneurysm
50 while remaining detachably attached to the pusher tube 106. The implant can include
an embolic braid that expands to contact aneurysm walls as illustrated, an embolic
braid that forms an alternative shape, an embolic coil that winds within the aneurysm,
and/or other suitable material for an occlusion device. Figure 2D represents the implant
102 in a final implanted position immediately prior to detachment of the implant 102
from the pusher tube 106. At this step and all steps prior, the implant 102 can be
retracted or otherwise repositioned by virtue of the implant's attachment to the pusher
tube 106. At this and prior steps, attachment of the implant 102 to the pusher tube
106c is maintained by inhibiting the securing member 114 from passing through the
securing ring 112 by maintaining the pull wire 116 to extend within the securing ring
112.
[0048] Figure 2E illustrates a view of the system 100 at a position distal to the system
100 and looking in the proximal direction as indicated in Figure 2D. The securing
member 114 is illustrated as overlapping the securing ring 112. The overlap of the
securing member 114 and the securing ring 112 inhibits the securing member 114 from
passing through the opening 113 of the securing ring 112.
[0049] Figure 2F illustrates an initial step for detaching the implant 102 from the pusher
tube 106. The pull wire 116 can be configured such that a user can pull a distal portion
of the pull wire in a proximal direction in relation to a distal portion 122 of the
pusher tube 106. The pull wire 116 can be manipulated similar to pull wires in mechanical
engagement/deployment systems as known to a person of ordinary skill in the art. Immediately
after the pull wire is retracted, the securing member 114 can begin to move through
the opening 113 of the securing ring 112, particularly if the elongated portion 121
of the securing wire 120 is under tension. Alternatively, the securing wire 120 can
remain extended through the opening 113 of the securing ring 112 until the system
100 is further manipulated.
[0050] Figure 2G illustrates a view of the system 100 at a position distal to the system
100 and looking in the proximal direction as indicated in Figure 2F. The securing
member 114 is illustrated as positioned centrally within the opening 113 of the securing
ring 112. The removal of the pull wire 116 allows the securing member 114 to move
so that it no longer overlaps the securing ring 112. Figure 2G illustrates that the
securing member 114 is sized to move through the opening 113 of the securing ring
112 when the opening 113 of the securing ring is unobstructed by the pull wire 116
(or other obstruction).
[0051] Figure 2H illustrates the pusher tube 106 and securing wire 120 retracted from the
implant 102. Once the pull wire 116 is retracted from the opening 113 in the securing
ring 112 of the implant 102, the securing member 114 is able to move through the opening
113. As illustrated, the securing wire 120 is affixed to the pusher tube 106 by an
attachment portion 121 and is therefore retracted by virtue of the pusher tube 106
being retracted. Alternatively, the securing wire 120 need not be affixed to the pusher
tube 106, and in such cases the securing wire 120 can be configured to be retracted
independent of the pusher tube 106. In either alternative, optionally, the distal
portion 122 of the pusher tube 106 can elongated to cause the distal end of the pusher
tube 106 to move distally toward the securing member 114, thereby pushing the securing
ring 112 over the securing member 114.
[0052] Once detached, the implant 102 can be difficult to retract or otherwise reposition
compared to the ease with which the implant 102 can be retracted and repositioned
prior to detachment. The pusher tube 106, pull wire 116, and securing wire 120 can
be retracted through the microcatheter 104. The microcatheter 104 can remain in place
to provide a conduit for delivery of additional treatment devices, or the microcatheter
104 can be retracted together with the pusher tube 106, pull wire 116, and securing
wire 120.
[0053] Figure 3A is an illustration of an example implant 102a including a substantially
tubular braided mesh body 108a. The body 108a as illustrated includes a first aperture
105 and a second aperture 130 at either ends of the tube 108a. The first aperture
105 can be oriented at a first region 126 of the body 108a. The securing ring 112
can be positioned on the first region 126 of the body. The second aperture 130 can
be oriented on a second region 128 of the body 108a. The securing ring 112 can be
attached to the body 108a at the first aperture 105. The second aperture can be a
free open end of the body 108a.
[0054] The first region 126 represents the region closest to the engagement/deployment system
when the implant 102a is positioned within the aneurysm 50. If portions of the implant
102a are retracted into the microcatheter 104 for redeployment, the first region 126
enters the microcatheter before the second region 128.
[0055] Figure 3B is an illustration of another example implant 102b including a braided
sack body 108b having an aperture 105 on a first region 126 with the securing ring
112 affixed at the aperture 105 similar to the first aperture 105 of the implant 102a
illustrated Figure 3A. The implant 102b illustrated in Figure 3B lacks a second aperture
130 on its second region 128b.
[0056] Figure 4A is an illustration of an example flexible distal portion 122a of a pusher
tube 106a. The flexible distal portion 122a can include a flexibility array 124a that
includes a helical cut.
[0057] Figure 4B is an illustration of another example flexible distal portion 122b of a
pusher tube 106b. The flexible distal portion 122b can include a flexibility array
124b that includes arcuate circumferential interference cuts.
[0058] Figures 5A through 5E are a sequence of illustrations during a treatment of an intravascular
implant system having a pusher tube 106c having a compressibly resilient distal region
122c.
[0059] Figure 5A is an illustration of the implant 102 being pushed distally by the pusher
tube 106c. Similar to as illustrated and described in relation to Figure 1 and Figure
2A, the implant 102 is detachably attached to the pusher tube 106c by virtue of the
securing wire 120 and pull wire 116 extending through the opening 113 in the securing
ring 112 of the implant 102. As illustrated in Figure 5A, the distal region 122c is
compressed. The distal region 122c is held in compression due to tension on the elongated,
attachment portion 121 of the securing wire 120. The attachment portion 121 under
tension extends from the securing ring 112 to a coupling of the portion 121 to the
inner surface 118 of the pusher tube 106. The securing member 114 is inhibited from
moving through the securing ring 112 by virtue of the pull wire 116 extending through
the securing ring 112 and the relative diameters D1, D2, D3 of the securing ring opening
113, securing member 114 and pull wire 116. The securing member 114 presses against
a distal surface SA3 of the securing ring 112 while the attachment portion 121 of
the securing wire 120 is attached to the pusher tube 106c in a proximal direction
in relation to the compressed region 122c.
[0060] The tube 106c can further include a flexible region 122a, 122b as illustrated in
Figures 4A and 4B. In such examples, the flexible region 122a, 122b is preferably
positioned in a proximal direction in relation to the compressed region 122c.
[0061] Figure 5B illustrates the implant 102 being positioned in an aneurysm 50 while remaining
attached to the pusher tube 106c. The compressed region 122c remains compressed. The
implant 102 can self-expand in the sac of the aneurysm 50.
[0062] Figure 5C illustrates the implant 102 expanded to a final implanted position within
the aneurysm 50. The implant 102 remains attached to the pusher tube 106c while the
compressed region 122c remains compressed. At this and prior steps, the implant 102
can be retracted proximally by retracting the pusher tube 106c proximally. At this
and prior steps, attachment of the implant 102 to the pusher tube 106c is maintained
by inhibiting the securing member 114 from passing through the securing ring 112 by
maintaining the pull wire 116 to extend within the securing ring 112.
[0063] Figure 5D is an illustration of the instant the pull wire 116 is retracted to exit
the securing ring 112. The compressed region 122c is illustrated as compressed. Without
the pull wire 116 in the opening 113 of the securing ring 112, the securing member
114 of the securing wire 120 is free to move through the opening 113 of the securing
ring 112. The securing member 114 is no longer inhibiting the compressed portion 122c
from elongating, and the securing member 114 begins to decompress. Expansion of the
compressed portion 122c can push the securing ring 112 over the securing member 114.
[0064] Figure 5E is an illustration of the compressed portion 122c elongated as a result
of being free to decompress as described in relation to Figure 5D. The distal portion
122c can elongate to push the securing ring 112 of the implant 102 distally. In some
instances, the distal portion 122c can push the securing ring 112 with a force launch
the securing ring 112 away from the distal end of the pusher tube 106 to create separation
between the securing ring 112 and the pusher tube 106. The securing member 114 and
lumen 107 of the pusher tube within the distal region 122c can be sized such that
distal region 122c can elongate over the securing member 114, thereby moving the securing
member 114 into the lumen 113 of the pusher tube 106.
[0065] Figures 6A through 6D are a sequence of illustrations during a treatment of an intravascular
implant system 200 lacking a pusher tube.
[0066] Figure 6A illustrates the implant 102 positioned within a microcatheter 104. The
implant 102 can include a body 108 and securing ring 112 similar to as described elsewhere
herein. The engagement/deployment system delivering the implant 102 through the microcatheter
104 can include a pull wire 116 similar to as described elsewhere herein and a securing
wire 220. The securing wire 220, in addition to including a securing member 114 as
described elsewhere herein can further include a pushing member 222 positioned in
a proximal direction in relation to the securing ring 112. Configured as such, the
engagement/deployment system need not include a pusher tube 106, 106a-c.
[0067] As illustrated, the pull wire 116 and securing wire 220 extend through the opening
113 of the securing ring 112. As illustrated in Figures 1B and 1C, the sum of the
securing member diameter D2 and pull wire diameter D3 can be greater than the inner
diameter D1 of the securing ring 112 to thereby inhibit the securing member 114 from
passing through the opening 113 of the securing ring 112 when the pull wire 116 is
in place through the securing ring 112. As illustrated in Figure 6A, the pushing member
222 has a diameter D5 such that the sum of the pushing member diameter D5 and pull
wire diameter D3 is greater than the inner diameter D1 of the securing ring 112 to
thereby inhibit the pushing member 222 from passing through the inner diameter D1
of the securing ring 112. The securing member 114 and pusher member 222 are each inhibited
from moving through the opening 113 in the securing ring 112 due to the extension
of the pull wire 116 through the securing ring 112.
[0068] When the securing wire 220 is pushed distally, the pusher member 222 moves to engage
the proximal surface SA2 of the securing ring 112.
[0069] Figure 6B illustrates the implant 102 positioned within an aneurysm 50. At this and
prior steps, the securing wire 220 can be moved proximally to translate the securing
ring 112, and thereby a proximal portion 126 of the implant 102 proximally for repositioning
and/or retraction of the implant 102. The securing member 114 can be moved to engage
the distal surface SA3 of the securing ring 112 when the securing wire 220 is pulled
proximally.
[0070] Figure 6C illustrates the system 200 after the pull wire 116 is translatable in the
proximal direction to exit the opening 113 in the securing ring.
[0071] Figure 6D illustrates the securing wire 220 translated in the proximal direction
to exit the opening 113 in the securing ring 112 when the pull wire 116 is absent
from the opening 113.
[0072] The descriptions contained herein are examples of embodiments of the invention and
are not intended in any way to limit the scope of the invention. As described herein,
the invention contemplates many variations and modifications of the intravascular
implant system, including alternative materials for component parts, and/or alternative
geometries of component parts as would be apparent to those having ordinary skill
in the art to which this invention relates and are intended to be within the scope
of the claims which follow.
[0073] Embodiments
- 1. A method of deploying an intrasaccular implant in an aneurysm, the method comprising:
selecting a system comprising a microcatheter, a pusher tube, a securing wire comprising
a radially extending securing member, a pull wire, and an intrasaccular implant comprising
a securing ring;
positioning the system in a delivery configuration such that pusher tube, securing
wire, pull wire, and implant are positioned within the microcatheter, the pusher tube
is in the proximal direction in relation to the securing ring, the securing wire extends
through the securing ring and pusher tube such that the securing member is positioned
in the distal direction from the securing ring, and the pull wire extends through
the pusher tube and the securing ring;
moving the implant in the distal direction through the microcatheter by moving the
pusher tube, pull wire, and securing wire in the distal direction;
extending the intrasaccular implant into a sac of the aneurysm;
retracting the pull wire in the proximal direction to free the pull wire from the
securing ring; and
retracting the securing wire from the securing ring by moving the securing member
through the securing ring when the pull wire is free from the securing ring.
- 2. The method of embodiment 1, wherein the step of extending the intrasaccular implant
into the sac of the aneurysm further comprises allowing the implant to self-expand
in the sac.
- 3. The method of embodiment 1, further comprising:
maintaining attachment of the implant to the pusher tube by engaging the securing
member to a distal surface of the engagement ring while engaging a distal surface
of the pusher tube to a proximal surface of the engagement ring.
- 4. The method of embodiment 3, wherein maintaining attachment of the implant to the
pusher tube further comprises inhibiting the securing member from passing through
the securing ring by maintaining the pull wire to extend within the securing ring.
- 5. The method of embodiment 4, wherein retracting the securing wire from the securing
ring further comprises retracting the pusher tube in the proximal direction while
the securing wire is coupled to the pusher tube.
1. A system for deploying an intrasaccular implant to occlude an aneurysm, the system
comprising:
the intrasaccular implant comprising a securing ring thereon, the securing ring comprising
a proximal surface and an opening comprising an inner diameter;
a pusher tube comprising a distal surface sized to engage the proximal surface of
the securing ring and positioned to face the proximal surface of the securing ring;
a securing wire extending through a lumen of the pusher tube and the opening of the
securing ring, the securing wire comprising an extended securing member thereon positioned
on an opposite side of the securing ring in relation to the pusher tube, the securing
member comprising a securing member diameter measuring less than the inner diameter
of the opening of the securing ring; and
a pull wire extending through the lumen of the pusher tube and the opening of the
securing ring, the pull wire comprising a pull wire diameter such that the sum of
the securing member diameter and the pull wire diameter measures greater than the
inner diameter of the opening of the securing ring.
2. The system of claim 1, wherein the intrasaccular implant, pusher tube, securing wire,
and pull wire are sized to fit within a microcatheter.
3. The system of claim 2, wherein the intrasaccular implant comprises a braided mesh
that is self-expandable upon exiting the microcatheter.
4. The system of any one of the preceding claims,
wherein the opening of the securing ring comprises a substantially circular shape
defined by the inner diameter,
wherein the securing member comprises a substantially spherical shape defined by the
securing member diameter, and
wherein the pull wire comprises a substantially circularly shaped perimeter defined
by the pull wire diameter.
5. The system of any one of the preceding claims,
wherein the pull wire is movable to exit the opening of the securing ring, and
wherein the securing wire is movable to pass the securing member through the opening
in the securing ring when the pull wire has exited the opening of the securing ring.
6. The system of any one of the preceding claims, wherein the securing wire is coupled
to an inner surface of the pusher tube by an attachment portion.
7. The system of any one of the preceding claims, wherein the pusher tube comprises a
flexible portion at a distal region of the pusher tube, the flexible portion comprising
greater flexibility compared to a majority of the pusher tube.
8. The system of any one of the preceding claims,
wherein the intrasaccular implant comprises a cavity therein, and
wherein the securing member and a portion of the pull wire are disposed in the cavity
of the intrasaccular implant.
9. The system of any one of the preceding claims, wherein the pusher tube comprises a
compressibly resilient portion at a distal region of the pusher tube.
10. The system of claim 9,
wherein the securing member of the securing wire is engaged to the securing ring,
and
wherein the compressibly resilient distal region is compressed due to tension in the
securing wire over a portion of the securing wire extending from the securing ring
to a coupling of the portion of the securing wire to the inner surface of the pusher
tube.
11. The system of claim 9 or claim 10,
wherein the pull wire is movable to exit the securing ring, and
wherein the compressibly resilient distal region is configured to expand and push
the securing ring over the securing member when the pull wire has exited the securing
ring.
12. An intravascular treatment system comprising:
an implant comprising an embolic body and a securing ring affixed to the body, the
securing ring comprising a proximal surface, a distal surface, and an opening comprising
an inner diameter;
a pull wire extending through the opening of the securing ring and comprising a pull
wire diameter; and
a securing wire extending through an opening of the securing ring and comprising an
extended securing member thereon and an extended pusher member thereon, the securing
member positioned in the distal direction in relation to the distal surface of the
securing ring and comprising a first diameter, the pusher member positioned in the
proximal direction in relation to the proximal surface of the securing ring and comprising
a second diameter, the first diameter dimensioned such that the sum of the pull wire
diameter and first diameter is greater than the inner diameter of the securing ring,
and the second diameter dimensioned such that the sum of the pull wire diameter and
the second diameter is greater than the inner diameter of the securing ring.
13. The system of claim 12,
wherein the securing member is movable to engage the distal surface of the securing
ring when the securing wire is pulled proximally, and
wherein the pusher member is movable to engage the proximal surface of the securing
ring when the securing wire is pushed distally.
14. The system of claim 12 or claim 13,
wherein the securing member and pusher member are each inhibited from moving through
the opening in the securing ring due to the extension of the pull wire through the
securing ring.
15. The system of any one of claims 12 to 14,
wherein the pull wire is translatable in the proximal direction to exit the opening
in the securing ring, and
wherein the securing wire is translatable in the proximal direction to exit the opening
in the securing ring when the pull wire is absent from the opening.